Resolution of acute kidney injury following intensive dialysis for oxalate nephropathy

Oxalate nephropathy refers to the deposition of calcium oxalate crystals within the renal parenchyma. The subsequent tubular-interstitial inflammation results in acute kidney injury and/or chronic kidney disease. This condition occurs in the setting of hyperoxaluria or increased urinary excretion of oxalate. Enteric hyperoxaluria is an increasingly recognized cause of secondary hyperoxaluria in which fat malabsorption promotes increased absorption of dietary oxalate. In the context of increasing utilization of bariatric procedures to address obesity, those who have undergone biliopancreatic diversions represent a growing subset of patients who later develop oxalate nephropathy. Presently, management options for affected individuals are limited to dietary interventions, and renal outcomes are poor. We present a case of stage III acute kidney injury from oxalate nephropathy in a bariatric patient who demonstrated renal recovery after decreasing serum oxalate levels through an early, intensive dialysis regimen.